JPS58177658A - Blood treating apparatus - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention is characterized in that a blood processing device is inserted into an extracorporeal circulation circuit, takes out blood of a patient through the extracorporeal circulation circuit, processes the blood in the blood processing device, and returns the blood to the patient. The present invention relates to a blood processing device for purification.

As blood processing devices, dialysis-type or filtration-type artificial kidneys, artificial lungs, artificial livers, plasma separation devices, and the like are currently used. In these blood processing devices, for example, treatment is performed by removing blood from a patient, performing the desired processing, and then returning the blood to the patient.At the end of the treatment, the blood processing device and the external It is necessary to return the blood remaining in the circulation circuit to the patient, a so-called residual blood collection operation. For example, in a dialysis-type artificial kidney, this residual blood amounts to about 100 to 300 TIIt, and since the patient has a weakened hematopoietic function, it is desirable to return as much of this residual blood as possible. This residual blood can be recovered by injecting physiological saline into the extracorporeal circulation circuit to push out the remaining blood, or by pumping air to push out the remaining blood in the same way, and then combining the physiological saline or air with the extracorporeal circulation circuit. This is done by returning the remaining blood into the patient by replacing it with the remaining blood.

Traditionally, this blood collection has been done manually, with operators monitoring the extracorporeal circulation circuit to prevent air from entering the body or large amounts of saline. In order to manage the inflow volume and collect enough blood by flushing away the blood that adheres to the walls of the tubes that make up the blood processing device and extracorporeal circulation circuit, the tubes and blood processing device of the extracorporeal circulation circuit. The vibrations were increasing to 4. This collection work requires, for example, at least 10 minutes. In general, blood processing is performed in parallel on a plurality of patients and is performed by one operator, so it is desired that the time required for blood collection be shortened.

Furthermore, in this type of blood processing device, it is necessary to sterilize the blood processing device and the inside of the extracorporeal circulation circuit, and if the sterilizing agent is not thoroughly washed away at the end of sterilization, there is a risk that the sterilizing agent may enter the body. Formalin, ethylene oxide, etc. are generally used as sterilizing agents. Conventionally, it took a considerable amount of time to thoroughly wash away the sterilizing agent.

The purpose of the present invention is, for example, to shorten the collection time when collecting residual blood, and also to make it possible to perform the collection automatically, and furthermore, to make it possible to perform the cleaning efficiently when cleaning the extracorporeal circulation circuit. An object of the present invention is to provide a blood processing device.

According to this invention, a sub-circulation circuit is constructed including a sub-liquid treatment device inserted into the extracorporeal circulation circuit, and a means for circulating a liquid in the sub-circulation circuit is provided. In addition to controlling the means, when the circulation of the extracorporeal circulation circuit is stopped, the subcirculation circuit is controlled to the t-circulation state.Because it is configured in this way, for example, residual blood is collected.

After supplying physiological saline to the extracorporeal circulation circuit, the subcirculation circuit is put into a circulating state, so that the blood adhering to the inner wall of the blood processing device falls off by light, thereby reducing the amount of blood remaining in the blood processing device. This makes it possible to collect a sufficient amount of blood. Similarly, when cleaning the sterilizing agent, by keeping the sub-circulation circuit in a circulating state, it is possible to sufficiently count the amount of sterilizing agent remaining in the blood processing device.

Hereinafter, an actual example of the blood processing apparatus according to the present invention will be explained with reference to FIG. Blood taken out from the patient 11 through the arterial needle attached to the blood tube 12 in the first [9] is sent by a roller pump 13 attached to the blood tube 12, and is supplied to a so-called drip chamber 14.

In the drip chamber 14, air mixed in the blood is removed, and the blood that has passed through the drip chamber 14'ft is processed through a blood processing device 15, such as a dialyzer. The processed blood passes through another drip chamber 16 and is returned to the patient 11 through a blood pipe 17. This blood pipe12. Drip chamber 14. Blood processor 15. Drip chamber 16. The blood pipe 17 constitutes an extracorporeal circulation circuit 18 .

In order to control the circulation of the extracorporeal circulation circuit 18, a blood tube is
A clamp 19 is provided on the tube 12 to enable on/off control of blood flow through the blood tube 12. Similarly, a second pump 21 is provided on the patient 11 side of the tube 17. An air bubble detector 22 is provided in front of the clamp 210 on the side of the acid drip chamber 16 to detect air bubbles mixed into the blood flowing through the blood pipe 17.
This is detected by the bubble detector 22, which closes the sifter lamp 21 to prevent the bubbles from being supplied to the patient 11.

In this invention, a sub-circulation circuit including a blood processor 15 is constructed. For example, in FIG. 1, a roller pump 1
3 and the blood tube 12 between the clamp 19 and the blood tube 17 between the drip chamber 16 and the bubble detector 22.
are connected to each other through a side passage 23.

Therefore, the side road 23. Pump 13. Blood processor 15. Blood pipe 17. A sub-circulation circuit 24 is constructed by the @path 231.

A second pump 25 is provided in the side passage 23 to circulate the liquid in the sub-circulation circuit 24 and to stop the circulation.

In this example, the blood processing device 15 and the drip chamber 16 are arranged so that the flow rate in the blood processing device 15 can be repeatedly changed rapidly to improve blood collection.
A clamp 26 is provided on the blood tube between.

A case in which the operation of the configuration shown in FIG. 1 is applied to the recovery of residual blood will be described with reference to the time chart in FIG. 2. That is, after the dialysis treatment is completed, the arterial needle is removed from the patient 11 and inserted into the saline bottle 27 as shown by the dotted line. In the initial state, the clamp 19 opens as shown at time t1 in fs2 diagram A, and similarly the clamp 21% second
The clamp 25 is opened as shown in Figure BK, and the clamp 25 is closed as shown in the second diagram, that is, the extracorporeal circulation circuit 18 is placed in a circulating state.
The sub-circulation circuit 24 is brought into a non-circulating state. In this state, the roller pump 13f is activated as shown in FIG. 2E. Therefore, the saline from the saline bottle 27 is transferred to the blood pipe 12.
The blood is sent to the blood pipe 17 through the drip chamber 14t and the blood processor 15, and the blood existing under the internal pressure of the extracorporeal circulation circuit 18 is pushed by physiological saline and returned to the patient 111.

In this state, the clamp 26t is repeatedly opened and closed as shown in FIG. Clamp 2
6 is closed, the liquid pressure in the extracorporeal circulation circuit 18 rises as shown in FIG. As shown, close the lower clamp 26'' again to stop the flow, and then close the lower clamp 26''.
The opening and closing steps are repeated, and the flow rate of the liquid flowing through the blood processing device 15 is suddenly increased, slowed down, and then decreased, and the blood that has adhered to the blood is dropped due to the impact of this flow. be carried out effectively. Note that the repetitive control of the second pump 26 in this manner may be simply performed at regular intervals, or in FIG.
The comparator 31 compares this detected pressure with the upper and lower limits set by the setting device 29. When the arterial pressure reaches the upper limit, the clamp 26 is opened, and when the lower limit is reached, the pressure is detected. The clamp 26 may be controlled by the control circuit 32 by inputting the output of the 1-ratio articulator 31 to the control circuit 32 so as to close the clamp 26. In this way, the arterial pressure becomes the second
As shown in Figure F, it repeatedly rises and falls.

When a certain amount of physiological saline is supplied, generally an amount that is approximately the same as the total volume of the liquid in the extracorporeal circulation circuit 18, when the remaining blood is pushed out into the patient 11, the leading edge of the saline is When the patient reaches 11tC, the saline supply 1
-: Stop. For example, rotation pulses of the roller pump 13 are obtained by a pulse generator 33 and counted by a counter 34. The cumulative flow rate of saline is obtained from the count value of the counter 34, and when the flow rate reaches a predetermined value, a signal is issued from the counter 34 to the control circuit. That is, as shown in FIG. 2G, the amount of physiological saline supplied to the bone increases linearly from time t1, and when the cumulative supply value reaches the set value, the circulation in the extracorporeal circulation circuit 18 is stopped at that time ts. , puts the sub-circulation circuit 24 into a circulation state.

Clamp 1 as shown in Figure 2 A and BK respectively.
9 and 21 are respectively in the closed position IJK, and the clamp 25 is in the open position 1 [K as shown in the second diagram 4. J
'J'
The liquid in the self-acid treatment device 15 is circulated through the subcirculation circuit 24. In this case, the clamp 26 is turned on.

``Off control may or may not be performed. By circulating the physiological saline in the sub-circulation circuit 24 in this manner, blood adhering to the blood processing device 15 can be effectively removed. The circulation in the sub-circulation circuit 24 is stopped at a time point ts after the elapse of the time required to sufficiently circulate the blood adhering to the tube for an appropriate period of time;
The extracorporeal circulation circuit 18 is brought into a circulating state.

The completion of circulation in the sub-circulation circuit 24 may be detected by a timer, or the pulses from the roller pump 13 may be counted by a counter 35 as shown in Fig. 1, and the counted value may be known. . In this case, the counter 35 is set with a numerical value corresponding to the certain period of time. The control circuit 32 also controls the switch 36 so that the counters 34 and 35 switch the supply of pulses to the pump 13.
be done. When it is detected at time ts that the predetermined period of circulation in the sub-circulation circuit 24 has ended based on the counted value of the counter 35, the 2y block 19 degrees as shown in FIGS. 21 is opened and the clamp 23 is closed to stop the circulation in the auxiliary circulation circuit 24 and restart the circulation in the extracorporeal circulation circuit 18. As a result, the coralline saline is again supplied to the extracorporeal circulation circuit 18, and the mixture of blood and physiological saline that has been sufficiently circulated through the subcirculation circuit 24 is transferred to the patient 11.
sent to. The supply amount of physiological saline at this time is selected to be approximately the same as the liquid volume in the extracorporeal circulation circuit 18, and when this supply amount reaches the set value as shown in FIG. Stop supply.

The supply amount of physiological saline is also detected by the counter 34, for example. That is, as the counter 34, a plurality of set values can be set, and when each of the set values reaches a count value, an output is generated from a different terminal.In this example, the counter 34
The set value of S and 83 is set so that 83 is twice Ss. In this way, when the count value of the second set value SsK counter 34 is reached, at time t4, the control circuit 32 operates as shown in FIG.
As shown in , the clamp 21 is closed and the rotation of the differential 1130 is stopped to stop the circulation in the extracorporeal circulation circuit 18, and the collection of the remaining blood is completed.

As shown in FIG. 2H, the amount of physiological saline supplied from the saline bottle 27 increases from time t1 and increases from time t3 to ts.
i, that is, while the sub-circulation circuit 24 is in the circulating state, it remains constant, and increases again from time tm to t41, thus increasing the supply amount of saline to the saline bottle 2.
The detection may be based on the liquid level at 7, and the switching of circulation in the circulation circuits 18 and 24 may be controlled based on the detection. Also, the extracorporeal circulation circuit 18 starts from time ts.
The liquid inside the tube may be pumped out using air, for example, instead of using physiological saline.

Furthermore, there is a lot of blood adhering to the special KJffi liquid processing device 15,
In addition, since most of the liquid capacity in the extracorporeal circulation circuit 18 is that of the blood processing device 15, in order to mainly remove blood adhesion in the blood processing device 15, at least the subcirculation circuit 24 that passes through the blood processing device tsi and do it. Therefore, for example, as shown by the dotted line in FIG. 1, the inlet and outlet of the blood processing device 150 are connected by a pipe 37 to form a side path, and a roller pump 38 is provided on the pipe 37 to form the subcirculation circuit 24. Good too. In this case, the pump 38 functions both to circulate the liquid in the auxiliary circulation circuit 24 and to stop the movement of the liquid in the auxiliary circulation circuit 24 in the stopped state, and to open and close the rigid circulation circuit 24. It also serves as

As described above, according to the embodiment shown in FIG. 1 of the present invention, it becomes possible to automatically collect the residual blood during blood processing, and it is possible to automatically collect the remaining blood in the blood treatment.
With the circulation of the extracorporeal circulation circuit 18 in a stopped state, the subcirculation circuit 2
By using 4 as a circulating tube, it is possible to effectively remove the blood adhering to the inside and return it to the patient by supplying a small amount of physiological saline.

As mentioned above, the subcirculation circuit 24 can be effectively used not only for collecting residual blood but also for cleaning the extracorporeal circulation circuit 18. That is, after the extracorporeal circulation circuit is sterilized, a cleaning liquid is supplied into the extracorporeal circulation circuit 18 during cleaning of the sterilant, and then the circulation of the extracorporeal circulation circuit 18 is stopped and the subcirculation circuit 24 is placed in a circulating state, and the blood processing device 15 The sterilizing agent can be removed in a relatively short time by repeatedly passing the cleaning solution through the inside! It is possible to do it effectively.

Further, the present invention can be applied not only to an artificial kidney dialysis machine but also to various blood processing apparatuses.

[Brief explanation of the drawing]

FIG. 1 is a configuration diagram showing an example of a blood processing device according to the present invention, and FIG. 2 is a time chart for explaining its operation. 11: Patient, 12, 17: Blood pipe, 13: Roller pump, 14, 16: Drip chamber, 15: Blood processor, 18: Extracorporeal circulation circuit, 19, 21, 25
, 26: Clamp, 23: Side path, 24: Sub-circulation circuit.

Claims (1)

[Claims] (1) In a blood processing device in which a blood processing device is inserted into an extracorporeal circulation circuit, blood is circulated in a circulation circuit including at least the above-mentioned blood processing device and its subcirculation circuit, or its circulation is A blood processing device comprising an opening/closing means for stopping the circulation, and a control means for stopping the circulation of the extracorporeal circulation circuit and controlling the subcirculation circuit to a circulating state.